脑卒中伴吞咽障碍患者不同训练方法疗效观察.docVIP

脑卒中伴吞咽障碍患者不同训练方法疗效观察 　　[摘要] 目的 探讨脑卒中伴吞咽障碍患者不同训练方法的疗效。 方法 选取上海市徐汇区中心医院康复科2015年1月～2016年6月收治的脑卒中伴吞咽障碍鼻饲患者60例，将其随机分为对照组A、治疗组B、治疗组C，各20例。对照组A采用神经肌肉电刺激、舌肌运动训练、下颌运动训练和进食指导；治疗组B在对照组A训练方法上再加Mendelsohn训练法；治疗组C在对照组A训练方法上再加冰柠檬刺激。每天1次，每次30 min，连续训练12 d为1个疗程。观察三组患者治疗前后摄食-吞咽功能评分的变化情况及临床疗效。 结果 经过治疗后，治疗组B摄食-吞咽功能评分为（4.20±1.08）分，治疗组C摄食-吞咽功能评分为（6.20±0.77）分，两组与对照组A[（2.67±0.82）分]比较，差异有高度统计学意义（P 0.01）。治疗组B治疗有效率为80.00%，治疗组C治疗有效率为95.00%，两组与对照组A（45.00%）比较，差异有统计学意义（P 0.05）。 结论 神经肌肉电刺激、舌肌运动训练、下颌运动训练、进食指导结合冰柠檬刺激能够改善脑卒中伴吞咽障碍鼻饲患者的吞咽功能，是一套实用、效果佳的脑卒中伴吞咽障碍鼻饲患者的康复训练方法。 　　[关键词] 脑卒中；吞咽障碍；鼻饲；吞咽功能训练 　　[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210（2016）10（a）-0044-04 　　Observation on the curative effect of different training methods for stroke patients with dysphagia 　　LI Hong1i1 MIAO Shanzhi2▲ YANG Jian1 ZHANG Ying1 DING Shanshan1 WANG Meijun2 　　1.Department of Rehabilitation Medicine， Shanghai Xuhui Central Hospital， Shanghai 200031， China； 2.Shanghai Xuhui Federation of Disabled Persons， Shanghai 200030， China 　　[Abstract] Objective To explore the effect of different training methods for stroke patients with dysphagia. Methods Sixty stroke patients with dysphagia by nasal feeding admitted to Department of Rehabilitation Medicine， Shanghai Xuhui Central Hospital from January 2015 to June 2016 were selected. All cases were randomly divided into control group A， treatment group B and treatment group C， with 20 cases in each group. In control group A， the patients were treated with neuromuscular electrical stimulation， tongue muscle motor training， mandibular training and feeding direction； the patients in treatment group B were treated additionally with Mendelsohn method on basis of control group A； the patients in treatment group C were treated additionally with ice lemon stimulation on basis of control group A. Once a day， 30 min each time， 12 days was as a course. The changes of feeding-swallowing function scores before and after treatment， and the clinical efficacy of the three groups were observ